The Fluoride Debate

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TABLE OF CONTENTS

INTRODUCTION

HISTORY/
ENVIRONMENT

CENSORSHIP

THE FLUORIDE
DEBATE

BENEFITS
Question 1
Question 2
Question 3
Question 4
Question 5
Question 6
Question 7
Question 8

ALTERNATIVES
Question 9
Question 10
Question 11
Question 12


SAFETY
Question 13
Question 14

OVERDOSE
Question 15
Question 16
Question 17

DISEASES
Question 18
Question 19
Question 20
Question 21
Question 22
Question 23
Question 24
Question 25
Question 26
Question 27
Question 28
Question 29
Question 30
Question 31
Question 32
Question 33

PUBLIC
POLICY

Question 34
Question 35
Question 36
Question 37
Question 38
Question 39
Question 40

COST
EFFECTIVENESS
Question 41
Question 42
Question 43

CONCLUSION

PUBLIC POLICY

Question 38.
Why does community water fluoridation sometimes lose when it is put to a public vote?

ADA's Fluoridation Facts Short Answer
Voter apathy, blurring of scientific issues, lack of leadership by elected officials and a lack of political campaign skills among health professionals are some of the reasons fluoridation votes are sometimes unsuccessful.

ADA's Fluoridation Facts Long Answer
Despite the continuing growth of fluoridation in this country during the past decades, millions of Americans do not yet receive the protective benefits of fluoride in their drinking water. At the present time, only 62.2% of the population served by public water systems have access to fluoridated water.13 In 1992, approximately 70% of all U.S. cities with populations of more than 100,000 fluoridated their water, including 42 of the 50 largest cities (See Figure 6).220 In 1998, the U.S. Public Health Service revised national health objectives to be achieved by the year 2010. Oral Health Objective 10 deals specifically with community water fluoridation and states that at least 85% of the population served by community water systems should be receiving the benefits of optimally fluoridated water by the year 20108 At the time the objectives were revised, less than half of the states met the 85% goal (See Figure 7).

The adoption of fluoridation by communities has slowed during the past several decades. Social scientists have conducted numerous studies to determine why this phenomenon has occurred. Among the factors noted are lack of funding, public and professional apathy, the failure of many legislators and community leaders to take a stand because of perceived controversy, low voter turnout and the difficulty faced by an electorate in evaluating scientific information in the midst of emotional charges by opponents. Unfortunately, citizens may mistakenly believe their water contains optimal levels of fluoride when, in fact, it does not.

Clever use of emotionally charged "scare" propaganda by fluoride opponents creates fear, confusion and doubt within a community when voters consider the use of fluoridation.221, 222 Defeats of referenda or the discontinuance of fluoridation have occurred most often when a small, vocal and well organized group has used a barrage of fear-inspiring allegations designed to confuse the electorate. In addition to attempts to influence voters, opponents have also threatened community leaders with personal litigation.215 While no court of last resort has ever ruled against fluoridation, community leaders may be swayed by the threat of litigation due to the cost and time involved in defending even a groundless suit. In no instance has fluoridation been discontinued because it was proven harmful in any way.215, 216, 223

Adoption of fluoridation is ultimately a decision of state or local decision makers, whether determined by elected officials, health officers or the voting public. Fluoridation can be enacted through state legislation, administrative regulation or a public referendum. Fluoridation is not legislated at the federal level and is perceived in most states as a local issue. From 1989-94, 318 communities authorized fluoridation by administrative governmental action. In the same time period, 32 referenda were held with fluoridation authorization approved in 19 and defeated in 13.224 As noted above, referenda can be unsuccessful for a variety of reasons. Nonetheless, a community's decision to protect the oral health and welfare of its citizens must, in some cases, override individual objections to implement appropriate public health measures.

Repeat of Question 38.
Why does community water fluoridation sometimes lose when it is put to a public vote?

Opposition's Response

Millions of our tax dollars are used every year to promote fluoridation, and to stifle any information against it. (See 38-1: "Fluoridation Campaign Funded by Public Purse," by Pete McConnell, from Health Freedom News). Big industries also invest a fortune for the same purpose. Antifluoridationists have very limited funds to work with, but in spite of that, they win at the polls more often than not, because truth is on their side.

Since 1990 sixty-four cities have rejected fluoridation. Thirteen cities have quit, some after having had it for 30 to 40 years. (See 38-2: "Rejection of Water Fluoridation.")

Procter & Gamble, the makers of Crest toothpaste state, "In 1980, 41 fluoridation referenda were held in the United States; fluoridation was disapproved in 33 of these and approved in only 8."

"It is no coincidence that historically fluoridation has been implemented by legislative bodies, and voted out by citizens. The decision to purposely contaminate our entire water supply for the sake of a few (even if it worked) is contrary to thousands of years of societal wisdom and must be made in the dark, where the coin of the realm is power, and the barter consequence is not improved water safety for all, but a transfer of public resource to commercial interest." (See 38-3: "An Open Letter To: Mayors, City Council Members, Boards of Supervisors, Water District Boards and Managers, and other Keepers of the Well," by Jeff Green, director of Citizens for Safe Drinking Water, San Diego, CA).

One troubling question is: "How would an individual, or a parent of a child, who is concerned about the amount of fluoride they are ingesting, either because they are concerned about ingesting too much or not receiving enough, determine how much total fluoride they are ingesting from all sources; and how would they be able to adjust the total amount they are ingesting?" (Jeff Green).

"The Natick Fluoridation Study Committee conducted a thorough review of the scientific literature and made the following findings regarding the benefits and risks of water fluoridation." (See 38-5: "Should Natick Fluoridate?" 9/27/97). They list their findings, which are the very reasons why the majority vote "No."

If you read a few of the following excerpts from the State Dental Directors conference with the Public Health Service and Children's Bureau, held on June 6-8, 1951, you will better understand where the ADA got the ideas for many of their Fluoridation Facts. (See 38-6).

To quote a few:

"We must not let them say that it has got to have 100% approval, or advance as a valid objection the fact that it may possibly have some bad in it. ... To the question, Isn't fluoride the thing that caused mottled enamel? You have got to have an answer and it had better be good. ... Now we tell them this, that at one part per million dental fluorosis brings about the most beautiful teeth that anyone ever had. ... So when you get the answer on the question to toxicity, please write me at once, because I would like to know. ... One thing that is a little hard to handle is the charge that fluoridation is not needed. They talk of other methods and when they get through adding up all the percentages of decay that we can reduce by such methods, we end up in a minus. When they take us at our own word they make awful liars out of us. ... Now, why should we do a pre-fluoridation survey? Is it to find out if fluoridation works? No. We have told the public it works, so we cannot go back on that. ... and let me tell you this: the medical audience is the easiest audience in the world to present this to. ... you have got to knock their objections down. The question of toxicity is on the same order. Lay off it altogether, just pass it over. 'We know there is absolutely no effect other than reducing decay,' you say and go on. ... don't bring it up yourself. ... And be sure not to present the ordinance to the city council before you have had an opportunity to really sell them. ... If you can, ... keep fluoridation from going to a referendum. ... The University of Texas had a research project on some white mice. ... There was a rumor that this research project indicated that fluoridation of water supplies causes cancer. That has knocked the pins from under us. We do not know how to combat it. ... When this thing came out, we never mentioned it in Wisconsin. All we did was to get some publicity on the fact that there is less cancer and less polio in high fluoride areas. We got that kind of information out to the public, so that if the opposition did bring up the subject they would be on the defensive, rather than having us on the defensive." (See 38-6: "Behind the Scenes with the Fluorine Conspirators." Excerpts from 4th Annual Conference, State Dental Directors with the Public Health Service and the Children's Bureau, Federal Security Bldg., Washington, D.C., June 6/8/51).

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